Unknown Individual – Nephrology Physician, NPI 1356397830

Unknown Individual is a healthcare provider. based in Phila, Pennsylvania. specializing in Nephrology Physician. They hold a License No. MD-014379E (PA). The NPI Number for Unknown Individual is 1356397830

Main info

Organization
Inactive
56 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356397830
Phone
(215) 762-6144
Address
219 N BROAD ST
Deactivation Date
26 July 2023

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF PENNSYLVANIA
Secondary Phone
2158362440
Graduation Year
1970 (56 years ago)
PAC ID
1153381538
Group Practice PAC ID
3274578240
Professional Enrollment ID
I20060426000769
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 219 N BROAD ST

    5TH FLOOR

    PHILA, PA 191071519

    Phone: (215) 762-6144

    Fax: (215) 762-8366

    Type: Location

  • Three Parkway, 1601, Cherry Street, Philadelphia, Philadelphia County, Pennsylvania, 19103, United States

    SUITE 11511

    PHILADELPHIA, PA 191021321

    Phone: (215) 255-7822

    Fax: (215) 255-7825

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19107)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274578240View full group profile
NameSpecialtyState
Family Practice, Hospice/Palliative CarePA
Nurse PractitionerPA
Nurse PractitionerPA
Clinical Social WorkerPA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1356397830 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Nephrology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Phila, Pennsylvania in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

Similar Providers

TEMPLE PHYSICIANS INC

Internal Medicine Physician
PO BOX 820933
NPI: 1982680526

DR. IMARA R DISSANAYAKE (MD)

Nephrology Physician
Burger King, 101, East Olney Avenue, Olney, Philadelphia, Philadelphia County, Pennsylvania, 19120, United States
NPI: 1295796969

YOON J AHN (MD)

Nephrology Physician
2228 S BROAD ST
NPI: 1396782892

ERIC D NEWMAN (DO)

Nephrology Physician
2228 S BROAD ST
NPI: 1396786885

EDWARD J FILIPPONE (MD)

Nephrology Physician
2228 S BROAD ST
NPI: 1649211129

EDWARD J FILIPPONE MD PC

Nephrology Physician
2228 S BROAD ST
NPI: 1043246663

DR. EFUA ASAMOAH-ODEI (MD)

Internal Medicine Physician
227 N BROAD ST STE 301
NPI: 1043479082

ELLIOT CHAREN (M.D.)

Nephrology Physician
PO BOX 95000-2433
NPI: 1245492255

DARANEE CHEWAPROUG (DO)

Nephrology Physician
5501 OLD YORK RD
NPI: 1285884825